Jane Warner, self-employed nurse, has a few tips for those considering going it alone
A little over one year ago, I set myself up as an independent general practice nurse. To be frank, it isn’t going spectacularly well. However, my experiences should not deter those who wish to consider swapping their monthly pay cheque for freedom and flexibility.
The problem lies entirely with me; in common with the anatomical features of the majority of humanity, I have 206 bones in my body, but unfortunately not one of these could even be remotely described as entrepreneurial. A classic example of this occurred when I purchased my public liability insurance – an absolute prerequisite for anyone venturing to work independently. I turned down the option of the accompanying offer of free online advertising, considering it to be boastful.
Here are a few pointers worth reflecting on. Firstly, why would you even consider quitting your place of work? Most surgeries are warm, happy and congenial, based on teamwork, mutual respect and the genuine desire to focus on what really matters – the patients. If you happen to be employed in such a setting, a) why move at all, and b) do they have any vacancies?
Not everything in the garden is quite as rosy. This is the litany of just some of the key features of what some practice nurses have to put up with, and it’s truly dispiriting. For instance, no Agenda for Change because they can’t afford it, forelock- tugging to be permitted to attend professional updates, workplace bullying, no opportunity for clinical supervision, lack of rigorous appraisal, salary just a few pounds an hour greater than HCA rates, a tick- box culture, and managers who have little appreciation of what nurses do. If this represents your workplace culture, you can, and perhaps should, make the break. Perhaps to another practice, not necessarily into self- employment.
But before you make your move to independence, think very carefully. What sort of person are you? Do you find that you seem to achieve more outside any organisation you work for than within its confines? If so, becoming self-employed could be a good move. Square pegs are not happy being fitted into round holes – and if you don’t believe me, imagine Gaudi assembling a flat pack wardrobe, with Escher handing him the screwdriver.
Assuming you do go ahead, and you’ve contacted local medical centres to let them know what a wonderful person you are (without boasting), here are just a few of the survival tips I have found invaluable.
- Contact HM Revenue and Customs to let them know about your change of status. They are very helpful and will send you relevant advice.
- Keep records of everything connected with your work so that when you do complete a tax return, neither you nor your computer ends up in a cold sweat. I print everything off in case data back up fails.
- Ensure you have both public and medical malpractice liability insurance in addition to your professional indemnity.
- Charge a fair rate for your professional services. Remember you effectively have no pension, no annual leave and no sick pay. A warning: in over ten years of employment my days of sickness could have been counted on the fingers of one hand. The first thing I did on becoming self employed was to fall, losing the use of my right hand.
- Pay your National Insurance contributions. I do this quarterly.
- Set aside regular time to read and reflect on clinical journals and update yourself professionally.
- Find a way which both protects anonymity and allows you to follow up your actions, e.g., if you are involved in cervical screening.
- When you receive payment, do not break open the champagne, however tempting this might seem. Weeks may go by before your next pay cheque arrives.
- Prepare to earn perhaps 30% of your previous salary – but cheer up – you can economise. It’s the only career move which allows you to combine feeling pulses with eating them.